St Petroc's Care Home

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. At our last assessment we rated this key question inadequate. At this assessment the rating has changed to good. This meant people were safe and protected from avoidable harm.

The service was now safe, and people consistently reported they were well cared for. People were not being restrained and the service now had policies detailing how staff should react and support individuals if they declined planned care.

Risks were mitigated effectively and staff used equipment correctly when supporting people to mobilise. Staffing levels were more than sufficient to meet people’s need and staff were able to spend time chatting with people. People’s dignity was consistently respected.

Staff understood local safeguarding procedures and their role in protecting people from abuse. Incidents were fully documented and opportunities for learning valued.

The improvements meant the service was no longer in breach of regulations.

This service scored 72 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

At the last assessment we found the significance of accidents and incidents had been downplayed in the service’s records. This meant it was not possible for learning to be identified from these events.

At this assessment we found the quality or record keeping had improved and staff reported the information about incidents that occurred was now accurately recorded.

Staff acknowledged the issue identified during the last assessment and had engaged positively with the provider to improve people’s experiences. All staff were now confident that any safety issues they raised would be investigated and addressed.

Staff feedback about changes to people’s support needs had resulted in prompt referrals to professionals and the introduction of additional equipment where necessary to ensure people’s safety.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services.

The provider had robust processes for identifying and assessing people’s needs before they moved into the service. One of the service’s management team reviewed information shared by commissioners and visited people in their homes to gain a full understanding of their individual needs and preferences. Managers comments included, “I have done one assessment with [another manager]. On paper the person was suitable but when we went to visit they were not so the placement was declined” and “We are not taking any risks with referrals here”. Health professionals told us, “They are now being more particular about the residents that they accept, keeping in mind the skillset of the staff”.

All prospective new placements at St Petroc’s Care Home were reviewed and authorised by the provider’s compliance manager. Although the service was operating significantly below capacity the provider was limiting new admissions to 1 per fortnight. This ensured staff and people who used the service had time to get to know people when they moved in.

The service shared information promptly and appropriately with partners during any transfers of care to help ensure people’s needs were fully understood and consistently met.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider shared concerns quickly and appropriately.

At the last assessment people reported witnessing, and being the victims of, abuse and mistreatment by members of staff. Staff also raised concerns that people had been abused and, when this had been reported to management, nothing had been done to prevent similar events reoccurring. Records showed people had been restrained and provided with personal care against their will.

During this assessment we found no evidence of abuse or unplanned restraint by staff.

People and their relatives told us they were safe and well cared for at St Petroc’s. Their comments included, “I have lived here for 3 months after a series of illnesses that have endangered my life, and I have also experienced respite care in other homes, but this home is way better. Staff are responsive” and “The change in staff has been good, now staff do a good job.”

Staff had received additional training in safeguarding adults and now had a full understanding of their duties and role in ensuring people were protected from abuse. Staff were confident any safety concerns they reported to managers would be investigated and information about how to make safeguarding referrals was readily available. Staff comments included, “People are safe here and I am happy here”, “I think people are safe, we are doing our best. I think people are quite happy” and “If I had concerns I would tell safeguarding straight away. Nothing has happened recently but I won’t be brushed off anymore. It does feel different now”.

Staff provided effective and compassionate support to a person who became upset in the dining room during the second day of the assessment. Staff said, “Restraint does not happen no more”, “No restraint whatsoever” and “No restraint happening. There is none of that now”.

All staff had completed breakaway training since the last assessment and now understood the provider’s policy was not to restrain people. The compliance manager told us, “We are really clear we do not do use restraint and our policy is that we do not restrain people. This has been made very clear throughout. That was done initially with training, a mix of videos, presentations and discussing of specific residents in the service”.

The requirements of the Mental Capacity Act were understood by managers and staff who respected people’s decisions and choices.

The provider worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

At the last assessment we found risks to people and staff had not been mitigated and staff reported inappropriate moving and handling techniques had been used.

During this assessment we found risks had been identified and mitigated and that staff now supported people to mobilise safely.

People were supported to mobilise safely, and we observed lifting equipment was used correctly when required. People told us, “I now walk around with support feeling happy, which I thought I’d never say” and “I’m aided by the staff to walk semi-independently within my room”. Where people had experienced falls their care needs had been reviewed, additional equipment requested when necessary and prompt referrals made to health professionals for additional guidance and support. Staff reported no concerns about inappropriate moving and handling techniques during this assessment and one staff member commented, “No drag lifts going on, if it did or if anything happens we tell managers about it and it does get addressed”.

People’s care plans included guidance for staff on how risks to people’s skin integrity should be mitigated. We observed that necessary pressure-reliving equipment was used appropriately during both days of our assessment.

Where people were known to decline support their care plans now included guidance for staff on how to ensure safety while respecting their wishes. During the first day of the assessment, one person declined support to wash; staff left the person’s room and reported the issue to the acting manager. After a short time the acting manager returned to the person’s room and again offered support which was accepted. This approach of changing faces when care was declined was detailed in the person’s care plan and worked effectively to manage risks associated with possible self-neglect. Staff told us, “If someone declined support, we will change faces or managers will help out” “We can’t push [Person’s name], we don’t force anyone” and “[The acting manager] is helping out with personal care quite a lot”. Professionals commented, “The staff are much more adaptable and rather than working to get the task done, are now working in a person-centred way and adapting care to the resident’s needs”.

Where additional monitoring had been introduced to ensure people’s safety this information had been shared with staff via the shift handover process. However, people’s care plans had not consistently been updated with this information. This meant there was a risk these duties were not fully understood by staff. Following feedback, people’s care plans were updated to include this information.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

The service was well maintained, and people’s bedrooms had been decorated with personal items. Maintenance records showed issues staff reported had been promptly addressed and resolved.

There were effective processes to ensure all necessary safety checks of the environment were completed and firefighting and lifting equipment had been regularly serviced. Plans had been developed detailing the individual support people would need in an emergency evacuation and necessary testing of the fire alarm and emergency lighting system completed. Maintenance records showed issues had been promptly reported, addressed and resolved.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs.

At the last assessment staffing levels at night were insufficient to meet people’s needs and training provided had been ineffective.

During this assessment, we found night staffing levels had increased and additional training and support had been provided to all staff.

Although occupancy levels had decreased since the last assessment and the annex, which was remote from the main building, was not in use, night staffing levels had been increased. Rotas were well organised and records showed the service had been constantly staffed as if full. Staff told us, “There is enough staff, people are safe”, “There is plenty of staff” and “Now we have enough staff to look after people, there is no need to rush”.

People were complimentary of the staff team and the care they provided. They told us staff responded quickly to any request for help and commented, “They do come if I press the buzzer”, The staff are very good” and “There are enough staff on duty”. Professionals said, “It appears that care is more person centred, and the overall attitude of the staff is more positive and engaging with the residents”.

Records showed staff had been supported to complete regular training updates. Staff told us, “We have had loads of training, there have been so many people coming in and talking to us”.

All staff received regular supervision and team meetings were held frequently to provide opportunities for staff to raise questions and share learning. Managers told us, “We are able to have staff attend supervision and training as there is plenty of staff around in the afternoon”.

Staff were recruited safely. All necessary pre-employment checks, including Disclosure and Barring Service checks had been completed to ensure prospective staff were suitable for employment in the care sector

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

The service was clean and cleaning schedules were being reviewed and updated to help ensure all areas were regularly cleaned. Cleaning staff were on duty during both site visits and visitors commented positively on the cleanliness of the service and told us “It’s lovely, clean and an impressive building”.

No concerns were raised by people or their relatives in relation to the laundry service and we found the laundry room was tidy and well organised.

Personal Protective Equipment was readily available to staff when required and staff understood how to manage infection control risks.

The provider did not always make sure that staff had clear guidance on the use of ‘as required’ medicines.

At the last assessment the provider did not have protocols detailing when and how staff should give ‘as required’ medications to help people manage anxiety.

At this assessment we found there had been a reduction in the number of these medications with only one person having this type of medication. This person had capacity and staff told us, "If [Person’s name] is anxious we can give [an ‘as required’ medication], we say there is a tablet to help would you like one". However, where this medication had been used records had not been maintained detailing why the medication was needed or whether it had been effective.

Medicines were stored safely and given as prescribed. Relatives said, “The home is very good with medication and helping to keep residents well. While people’s comments included, “I take my own medication morning and night, I like to stay independent, the staff are very helpful” and “I take a lot of meds. During the last few months the staff noticed that I was showing signs of diabetes which the doctor has confirmed and for which I now take more medicines”.

The provider used an electronic Medication Administration Record System (eMAR) which staff reported worked well. These records were regularly audited by managers and any issues identified addressed. Staff told us, “We are counting every day and matching the stock every day so we can find any medication error, and they will investigate it”.

The provider had recently appointed a medication auditor who visited services, unannounced at night, to assess staff competence with medicines and reviewed the service’s performance in relation to medications. Any issues identified during these audits were reported to the provider’s compliance manager for further investigation.